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Biomedical subjects

M Gedebou

Publications and source records attributed to M Gedebou.

13 recordsLinked to original sources
PubMed1990

Antibiotic susceptibility of Escherichia coli isolates from inpatients with urinary tract infections in hospitals in Addis Ababa and Stockholm.

A high level of antimicrobial resistance of bacteria has been detected at the Tikur Anbessa Hospital (TAH), Addis Ababa, for many years. In contrast, at the Karolinska Hospital (KH), Stockholm, the level of resistance is low. Reported are the results of an investigation of the correlation between antibiotic usage and the antimicrobial resistance rates of Escherichia coli isolates from patients with urinary tract infections in these hospitals. At TAH the strains of E. coli isolated were considerably more resistant to all seven antibiotics tested. The level of multiresistance was 63% at TAH and 7% at KH. There were no significant differences in the total amount of antibiotics used in the two hospitals, except for antituberculosis agents. The strain biotypes and antibiograms, together with the length of patients' hospitalization before a positive urine culture was obtained, suggest that the majority of the strains from TAH were of nosocomial origin.

Cross Infection↗
PubMed1990

Ceftriaxone in the treatment of septicaemia due to multiple drug resistant bacteria.

Ceftriaxone, a highly effective, B-Lactamase resistant broad spectrum parenteral cephalosporin was used in the treatment of 26 consecutive patients with clinically and/or bacteriologically resistant infections at the Addis Ababa University Tikur Anbessa and Ethio-Swedish Paediatric Teaching Hospitals. The patients who had failed to respond to a combination of two or more previously appropriate antibiotics were treated with ceftriaxone administered in two divided doses (daily 50-100 mg/kg) in children and a single dose of 2-3 gm in adults for an average duration of 9.9 days. Of the 21 evaluable cases 16 (76%) were cured, three died and two developed superinfection with Pseudomonas and Staphylococcus species. Primary pathogenic bacteria were eradicated from all the 21 bacteraemic patients on the third day of therapy. Twelve of the 21 patients had serious underlying conditions. Except for the two superinfections, the results of the trial confirm that ceftriaxone is a very potent and effective agent in the treatment of resistant bacteraemic infections. No significant adverse effect of the drug was encountered during the therapy.

Adolescent↗
PubMed1988

Hospital-acquired infections among obstetric and gynaecological patients at Tikur Anbessa Hospital, Addis Ababa.

Seven hundred patients admitted to the wards of the Department of Obstetrics/Gynaecology of Tikur Anbessa Hospital, Addis Ababa, between January and July 1984 were studied for the incidence of nosocomial infections. The overall hospital infection rate was 17.0%, with wound infection at 47% followed by urinary-tract infection at 15%. Over 80% of the bacterial isolates were Gram-negative bacteria, the majority of which were multiply resistant to the commonly used antibacterial drugs. Some hospital risk factors have been identified. The findings are discussed in the light of reports on nosocomial infections from hospitals of developed countries.

Anti-Bacterial Agents↗
PubMed1988

Hospital-acquired infections among surgical patients in Tikur Anbessa Hospital, Addis Ababa, Ethiopia.

One thousand six surgical patients admitted between April 1983 and January 1984 to a hospital in Addis Ababa were studied for incidence of nosocomial infections. On admission, they were carefully examined clinically to exclude community-acquired infections and to determine any underlying risk factors. All patients were closely followed up for detection of developing nosocomial infections. Specimens collected from patients with clinically diagnosed bacterial infections were processed for culture; isolates were identified and tested for susceptibility to the locally used antimicrobial agents. Nosocomial infections were detected in 165 (16.4%) patients. Wound (59%), urinary tract (26%), and respiratory tract (6%) infections accounted for more than 90% of the infections. Fourteen of 18 deaths were attributed to nosocomial infections. About 72% of the patients were given prophylaxis, which was associated with infection (p less than 0.0005). Operations and other procedures were also associated with infection (p less than 0.0005). Anemia was found as a host risk factor (p less than 0.0005). Approximately 90% of the nosocomial pathogens were gram-negative bacteria, of which 84% were Enterobacteriaceae. They were mostly resistant to the commonly used antibiotics. Our findings should create awareness of the problem in this hospital and possibly in others in Addis Ababa and hence prompt measures for effective control.

Adolescent↗
PubMed1987

The bacteriology of nosocomial infections at Tikur Anbessa Teaching Hospital, Addis Ababa.

Patients admitted to a teaching hospital in Addis Ababa were studied for nosocomial infection. Of 2506 patients, 13% developed clinical infections, with the highest rate among obstetric/gynaecologic patients (17.0%). Wound infection was the most frequent type of nosocomial infection (49%) followed by urinary tract infection (25%). Antibiotic prophylaxis was given to 43% of the patients. Gram-negative bacteria comprised 88% of all isolated strains Enterobacteriaceae; 75% of all isolates were found in over 60% of the infection, Proteus 25%, Escherichia coli 20% and Klebsiella 19%. The most widely used antibiotics were ineffective against 65 to 85% of the Gram-negative strains. Cefotaxime and gentamicin were more effective. Staphylococcus aureus isolates were also similarly resistant, against which cephalothin, lincomycin and gentamicin were the more effective ones. Over 70% of the strains were multiple resistant. The findings underscore the need for a surveillance program and infection control system to reduce the high rate of infection and to institute appropriate guidelines for the use of prophylactic and therapeutic antibiotics.

Anti-Bacterial Agents↗
PubMed1987

Penicillin and tetracycline susceptibility of gonococci from Addis Ababa and incidence of penicillinase-producing strains.

One hundred and nine Neisseria gonorrhoeae strains were isolated from urethral discharge of male patients in a health centre in Addis Ababa, identified following conventional procedures, and tested for penicillin and tetracycline susceptibility by the agar dilution technique. World Health Organization reference strains were also tested as controls. Penicillinase producing N. gonorrhoeae (PPNG) were identified using Oxoid beta-lactamase detection papers. Minimal inhibitory concentration (MIC) values of penicillin varied between less than 0.01 mg l-1 and greater than 10.24 mg l-1 while those of tetracycline, between less than 0.25 mg l-1 and 4.0 mg l-1. About 64% of isolates were resistant to penicillin, requiring MICs of greater than or equal to 0.64 mg l-1: 26% were resistant to tetracycline, requiring greater than or equal to 2 mg l-1 for inhibition. The rate of simultaneous resistance to both antibiotics was 18%. PPNG comprised 49% of isolates, of which 23% were resistant also to tetracycline. Of 70 penicillin-resistant strains, 17 (24%) were non-PPNG.

Adolescent↗
PubMed1986

Aerobic gram-negative pharyngeal bacilli of adult Ethiopians: carrier rates and antibiograms.

One thousand pharyngeal swab specimens were processed for aerobic culture to determine the carriage rate of Gram-negative bacilli (GNB). The isolates were identified and their sensitivity determined to 11 antibacterial drugs following standard techniques. Similar pharyngeal carriage rates of GNB were found among the various groups of healthy subjects. Patients had higher colonization rates (27%) than healthy subjects (16%). The increase in prevalence of GNB seemed to be associated with underlying diseases and duration of hospitalization. Klebsiella (36%) was the most frequent genus amongst the 215 isolates of GNB followed by pseudomonas (13%), enterobacter (13%) and acinetobacter (10%). Others were less frequently isolated. Over 70% of all isolates were resistant to ampicillin (79%) and carbenicillin (72%); 55, 45 and 43% were resistant to cephalothin, tetracycline and streptomycin, respectively. The great majority of the strains were sensitive to the remaining six drugs. The hospital isolates were more resistant than the non-hospital isolates to most drugs tested. The hospital strains were also more often multiply resistant (89%) than the non-hospital strains (60%). Sixty-five different resistance antibiograms of 1-10 drugs were observed among 191 strains. More varied types of antibiograms were observed among hospital strains. The high frequency of multiple drug resistance of the isolates is an indication of the extensive use of antibacterial drugs, indicating the need for a policy for judicious use of drugs.

Adult↗
PubMed1985

Salmonella and Shigella in adult diarrhoea in Addis Ababa--prevalence and antibiograms.

Ninety Shigella and 45 Salmonella strains were isolated from 1000 adult diarrhoeal out-patients from various hospitals and clinics in Addis Ababa. The Shigella species were isolated in the order of frequency of S. flexneri, S. dysenteriae, S. boydii and S. sonnei and the Salmonella in the order of Group C, Group B, S. typhi, other Group D and Groups A and E. Almost all Shigella isolates were sensitive to cephalothin, gentamicin, kanamycin, polymyxin B and trimethoprim-sulphamethoxazole. About 17% were sensitive to the 11 drugs tested. Multiple resistance was detected in 62%, the most common to six drugs (27%). All Salmonella isolates were sensitive to gentamicin, polymyxin B and trimethoprim-sulphamethoxazole. About 69% were sensitive to all drugs tested. 22% were multiply resistant and the most common was to eight drugs (18%).

Anti-Bacterial Agents↗